=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386977783
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KELLY LYNN ARGO PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/16/2009
-----------------------------------------------------
Last Update Date | 09/16/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 617 BEAR CREEK RD
-----------------------------------------------------
City | TUSCALOOSA
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35405-6473
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-345-0699
-----------------------------------------------------
Fax | 205-750-2184
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16 BROOKHAVEN DR
-----------------------------------------------------
City | TUSCALOOSA
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35405-1902
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-919-8211
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 16252
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------